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    Treating wounded warriors is motivational and humbling

    Timothy A. Miller, M.D., examining a soldier who is receiving treatment under UCLA's Operation Mend program.
    WHEN ASKED TO OFFER HIS craniofacial expertise and operate on soldiers seriously wounded in Iraq and Afghanistan, Reza Jarrahy, M.D., was enthusiastic to help. Dr. Jarrahy, who is fellowship trained in pediatric and craniofacial surgery, is well into his work with Operation Mend, a project in which soldiers with serious burns, the need for facial, nasal, lip and eyelid reconstructions and much more, receive free surgeries by UCLA's plastic surgeon faculty.

    Dr. Jarrahy, assistant professor, Division of Plastic and Reconstructive Surgery, UCLA School of Medicine, says that his Operation Mend patients have needed complex burn reconstructions; some have had severe craniofacial injuries involving extensive skeletal injuries, and soft tissue injuries and facial paralysis.

    THE GOOD FIGHT Though their injuries are devastating, their spirits and determination to get better are amazing, according to Dr. Jarrahy.

    "Personally, it is humbling to meet these soldiers who are making on a daily basis — I know it sounds cliché but — the ultimate sacrifice," he says. "...I met a [soldier] who has bilateral upper extremity amputation and total body burns, and he had just run a triathlon a week before. To meet someone who has had that sort of injury...who then comes back home and is going through all of these multiple surgical procedures and has time to train for and run a triathlon is amazing to me."

    The plastic surgeon who directs Operation Mend agrees. Timothy A. Miller, M.D., professor and chief, UCLA Division of Plastic and Reconstructive Surgery, says that he and colleagues have seen 26 Operation Mend patients and are in the process of operating on 16 of those. "Being a plastic surgeon puts you in a unique position to give back to these young men and women who have given so much to protect our families and our country," Dr. Miller says. "We have operated on 16 patients but have only finished three. Most of the patients require between seven to maybe nine operations. We have some that have had greater than 10 operations."

    Dr. Miller has come to much the same conclusion as his colleague, Dr. Jarrahy, as he has watched these patients endure the remarkable evolution wrought by these regrettably painful procedures.

    "As they go, you...see a very real change in their personalities. They are happier, but also almost all of them are men and women of unbelievable character. I have yet to hear anybody complain. As a matter of fact, it is the other way around. Several have told me that they are the lucky ones [because they survived]," Dr. Miller relates. While directing plastic surgery for Operation Mend, Dr. Miller has observed that almost all the soldiers have extraordinarily strong families to support them. Operation Mend, he explains, pays for family members, including spouses and children, to stay in UCLA accommodations while their loved ones are having surgery.

    "The other significant aspect is that they have been through truly an ordeal. Recovering from a major burn is probably the most painful thing and the most painful treatment that you can go through," Dr. Miller adds.

    BURNISHING SKILLS The surgeons involved in Operation Mend do more than learn about character; they hone their skills in the operating room — on some of the toughest of cases around.

    Operation Mend surgeon and assistant professor of surgery, Division of Plastic and Reconstructive Surgery at UCLA, Christopher Crisera, M.D., says that the there are unique aspects to these cases. The complexity of the injuries, with soft tissue trauma, burns, skeletal trauma, push the plastic surgeons to be innovative in how they employ basic reconstructive techniques.

    Dr. Crisera shares one such example: "Having to use remnants of previously-used flaps...in burned areas to reconstruct areas that are also burnt."

    Many of the soldiers have had initial stages of reconstruction and acute burn treatment at Brooke Army Medical Center prior to seeing the surgeons at UCLA, according to Dr. Crisera.

    "So, we have to work with what we are given and that is an additional variable in the complexity of the cases," he says. "You really need to set out a long-term plan and not try to bite off too much in any one operation."

    REPLICATING THE MODEL Operation Mend, according to UCLA literature, aims to serve as a model for other medical institutions interested in helping other wounded service members. The effort is the brainchild of Ronald Reagan UCLA Medical Center board member Ronald A. Katz, who recognized that providing excellent care to injured soldiers need not be limited to the U.S. Department of Veterans Affairs and the armed services. Operation Mend is a partnership among the surgeons and staffs of Ronald Reagan UCLA Medical Center, Brooke Army Medical Center and the V.A.-Greater Los Angeles Healthcare System. The Katz Family Foundation funds all uncovered costs associated with the project, including lodging for patients and family members.

    "Anybody would jump at the opportunity to be involved in a program like this once you see the horrifically injured young men and women. Often, they have a lot of self-consciousness and anxiety about their appearance when we first interact with them, and, because we end up doing the procedures in multiple stages, we establish relationships with them over the course of a number of months. You can see a lot of that anxiety and self-consciousness disappear as they start to feel more comfortable about their appearance and that, itself, is a function of surgery. I would absolutely encourage people to get involved; it is tremendously fulfilling," Dr. Crisera says.


    To contribute to the work of Operation Mend, or to volunteer as a Buddy Family, please visit http://operationmend.ucla.edu

    Lisette Hilton
    Lisette Hilton is a writer in Boca Raton, Fla., who heads up her company, Words Come Alive.


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